Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
10 Cards in this Set
- Front
- Back
Group Policies |
Medical insurance obtained through jobs |
|
Individual Policies |
Medical insurance for the self-employed, generally more expensive. |
|
Third Party Payer |
Insurance company or program that reimburses medical expenses |
|
Medical insurance |
Third party payer, insurance covers policyholders and dependents (aka private insurance) |
|
Medicare |
Third party payer, federal program that covers persons over 65 or those younger that fall into disability category. |
|
Medicaid |
Third party payer, federal/state program that provides health care coverage to certain populations of the poor. |
|
Workers' compensation |
Third party payer, program that provides coverage for individuals who are injured on the job or acquire job-related illnesses. |
|
TRICARE |
Third party payer, federal program that covers military personnel and families. |
|
CHAMPVA |
Third party payer, federal program that provides health care coverage to spouses and dependents of veterans with total service-related disabilities or those who died from service-related disabilities. |
|
Flow of Reimbursement |
(1) Pt. admitted to hospital (2) Diagnoses and procedures documented in medical records (3) Numeric codes assigned to diagnoses and procedures (4) Codes entered on claim form (5) Claim form submitted to insurance or Third party payer (6) Reimbursement paid to hospital |